How To Use HCPCS Code E2617

HCPCS code E2617 describes a custom fabricated wheelchair back cushion, including any type of mounting hardware. This code is used to identify the specific product and service provided to patients who require a customized back cushion for their wheelchair. In this article, we will explore the details of HCPCS code E2617, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS E2617?

HCPCS code E2617 is used to identify a custom fabricated wheelchair back cushion, any size, including any type of mounting hardware. This code is specific to the product and service of providing a customized back cushion for individuals who use wheelchairs. It is important to note that this code is not applicable for other types of cushions or supplies.

2. Official Description

The official description of HCPCS code E2617 is “Custom fabricated wheelchair back cushion, any size, including any type mounting hardware.” The short description for this code is “Enteral supp not otherwise c.” This description accurately represents the product and service that this code identifies.

3. Procedure

1. The provider begins by assessing the individual’s specific needs and requirements for a wheelchair back cushion.
2. Measurements are taken to ensure the proper size and fit of the cushion.
3. The cushion is then custom fabricated according to the individual’s measurements and specifications.
4. Any necessary mounting hardware is included and installed to ensure proper attachment to the wheelchair.
5. The custom fabricated wheelchair back cushion is then provided to the patient.

4. When to use HCPCS code E2617

HCPCS code E2617 should be used when a healthcare provider is providing a custom fabricated wheelchair back cushion, including any type of mounting hardware. This code is specifically for cases where a customized cushion is necessary to meet the individual’s unique needs and requirements. It is important to ensure that the cushion is custom fabricated and not a standard off-the-shelf product.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code E2617, healthcare providers should ensure that the documentation supports the need for a custom fabricated wheelchair back cushion. This may include detailed notes on the individual’s specific requirements, measurements, and any other relevant information. It is also important to include documentation of the installation of any mounting hardware, if applicable.

6. Historical Information and Code Maintenance

HCPCS code E2617 was added to the Healthcare Common Procedure Coding System on January 01, 1985. Since its addition, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. This code has remained unchanged since its inclusion in the coding system.

7. Medicare and Insurance Coverage

HCPCS code E2617 is eligible for coverage under Medicare. The pricing indicator code for this code is 57, which indicates that it is priced by other carriers. The multiple pricing indicator code is A, which means it is not applicable as HCPCS priced under one methodology. It is important for healthcare providers to verify coverage and reimbursement policies with Medicare and other insurance carriers.

8. Examples

Here are five examples of when HCPCS code E2617 should be billed:

1. A patient with a spinal cord injury requires a custom fabricated wheelchair back cushion to provide optimal support and pressure relief.
2. An individual with a congenital condition needs a customized wheelchair back cushion to accommodate their unique anatomical needs.
3. A patient with a degenerative condition requires a custom fabricated wheelchair back cushion to alleviate discomfort and prevent further deterioration.
4. An individual with a postural abnormality needs a customized wheelchair back cushion to promote proper alignment and prevent complications.
5. A patient with a history of pressure ulcers requires a custom fabricated wheelchair back cushion to prevent the recurrence of skin breakdown.